DIGITAL VERSUS CONVENTIONAL REMOVABLE DENTURES IN GERIATRIC PATIENTS: A COMPARATIVE LITERATURE REVIEW OF CLINICAL EFFICIENCY, MATERIAL BIOCOMPATIBILITY, AND PATIENT-REPORTED OUTCOMES

Abstract

This literature review provides a comparative analysis of digital versus conventional fabrication methods for removable complete dentures, with a specific focus on their application in the geriatric population. The conventional workflow, while established, presents significant burdens for elderly patients, including numerous, lengthy appointments. Digital workflows, utilizing CAD/CAM (milling) and additive manufacturing (3D-printing), offer a profound advantage in clinical efficiency, reducing the fabrication process to as few as two or three visits. This review synthesizes recent systematic reviews and clinical trials to compare these modalities across three critical domains for geriatric care: (1) clinical efficiency and process benefits, (2) patient-reported outcome measures (PROMs), and (3) material science, specifically biocompatibility and suitability for high-risk patients.

Evidence confirms the digital workflow is unequivocally superior in efficiency. Furthermore, the ability to archive the definitive prosthesis as a "digital duplicate" file represents a paradigm shift for providing rapid replacements for frail or institutionalized patients. While broad systematic reviews suggest patient satisfaction is often comparable between methods, high-evidence crossover trials where patients use both types report a significant preference for the fit, comfort, and retention of digital dentures. The most critical divergence, however, is in material properties. CAD/CAM milled PMMA demonstrates superior flexural strength, the lowest surface roughness, and significantly lower Candida albicans adhesion compared to conventional acrylic. Conversely, 3D-printed resins currently show the highest surface roughness and microbial adhesion. Furthermore, milled PMMA is the most hydrophilic, making it a physiologically targeted solution for geriatric patients with xerostomia. We conclude that while 3D-printing offers speed, the superior material properties of milled dentures make them the optimal clinical choice for high-risk geriatric patients.